Malleolar Fractures and Dislocations of the Ankle

  • William C. Hamilton


Ankle injuries are usually the result of indirect or torsional violence [5,31,32,41] which distorts the normal relationship between the talus and the tibiofibular mortise. Most commonly, the foot is fixed and the injury is sustained as a result of the tibiofibular mortise moving against the talus [77,83]. Most authors, however, have found it more convenient to speak in terms of motion of the talus with respect to the tibiofibular mortise [44]; this custom shall be observed in this text.


External Rotation Ankle Joint Ankle Fracture Ankle Injury Distal Fibula 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Alldredge RH: Diastasis of the distal tibiofibular joint and associated lesions. JAMAGoogle Scholar
  2. 115:.
    2136, 1940.Google Scholar
  3. 2.
    Arimoto HK, Forrester DM: Classification of ankle fractures: an algorithm. Am J Roentgenol 135: 1057, 1980.Google Scholar
  4. 3.
    Ashhurst APC, Bromer RS: Classification and mechanism of fractures of the leg bones involving the ankle. AMA Arch Surg 4: 51, 1922.Google Scholar
  5. 4.
    Bistrom 0: Conservative treatment of severe ankle fractures. A clinical and follow-up study. Acta Chir Scand (Suppl) 168: 1, 1952.Google Scholar
  6. 5.
    Bohler L: The Treatment of Fractures, 5th ed. New York, Grone & Stratton, 1956.Google Scholar
  7. 6.
    Bolin H: The fibula and its relationship to the tibia and talus in injuries of the ankle due to forced external rotation. Acta Radiol 56: 439, 1961.PubMedCrossRefGoogle Scholar
  8. 7.
    Bonnin JG: Injuries to the Ankle. New York, Grune & Stratton, 1950.Google Scholar
  9. 8.
    Bonnin JG: Injury to the ligaments of the ankle. J. Bone Joint Surg 47B: 609, 1965.Google Scholar
  10. 9.
    Bosworth DM: Fracture-dislocation of the ankle with fixed displacement of the fibula behind the tibia. J Bone Joint Surg 29: 130, 1947.PubMedGoogle Scholar
  11. 10.
    Burns BH: Diastasis of the inferior tibio-fibular joint. Proc Roy Soc Med 36: 330, 1943.PubMedGoogle Scholar
  12. 11.
    Burwell HN, Charnley D: Treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Joint Surg 47B: 634, 1965.Google Scholar
  13. 12.
    Cabrera C, Simonovich S: Major fractures of the ankle and their sequelae. Ed: J. Delchef, R de Marneffe, E Vander Elst. Proceedings of the 12th Congress of the International Society of Orthopaedic Surgery and Traumatology, TelAviv, Oct 9-12 1972.Excerpta Medica, Amsterdam, 1973.Google Scholar
  14. 13.
    Cave F (Ed): Ankle Injuries. Fractures and Other Injuries. Chicago, Year Book Medical, 1958.Google Scholar
  15. 14.
    Cedell CA: Supination-outward rotation injuries of the ankle. Acta Orthop Scand (Suppl) 110:1, 1967.Google Scholar
  16. 15.
    Cedell CA: Ankle lesions. Acta Orthop Scand 46: 425, 1975.Google Scholar
  17. 16.
    Close R: Some applications of the functional anatomy of the ankle joint. J Bone Joint Surg 38A: 761, 1956.PubMedGoogle Scholar
  18. 17.
    Colton CL: Fracture-diastasis of the inferior tibio-fibular joint. J Bone Joint Surg 50B: 830, 1968.Google Scholar
  19. 18.
    Cooper AP: On dislocations of the ankle joint. Clin Orthop 42: 3, 1965.Google Scholar
  20. 19.
    Cotton FJ: A new type of ankle fracture. JAMA 64: 318, 1915.Google Scholar
  21. 20.
    Cox FJ, Laxson WW: Fractures about the ankle joint. Am J Surg 83: 674, 1952.PubMedCrossRefGoogle Scholar
  22. 21.
    Dabezies E, D'Ambrosia R, Shoji H: Classification and treatment of ankle fractures. Orthopedics 1: 365, 1978.Google Scholar
  23. 22.
    D'Anca AF: Lateral rotatory dislocation of the ankle without fracture. A case report. J Bone Joint Surg 52A: 1643, 1970.PubMedGoogle Scholar
  24. 23.
    DeSouza Dias L, Foerster TP: Traumatic lesions of the ankle joint. The supination-external rotation mechanism. Clin Orthop ReI Res 100: 219, 1974.Google Scholar
  25. 24.
    Dupuytren G: On the Injuries and Diseases of Bones. Translated by F. LeGros Clark. London, The Syndenham Society, 1847.Google Scholar
  26. 25.
    Dupuytren G: Of Fractures of the Lower Extremity of Fibula and Luxations of the Foot. Med Classics 4: 151, 1939.Google Scholar
  27. 26.
    Ellison AE: A brief review of the literature on the ankle joint. Am J Sports Med 5: 226, 1977.PubMedCrossRefGoogle Scholar
  28. 27.
    Fahey JJ, Schlenker LT, Stauffer RC: Fracture dislocation of the ankle with fixed displacement of the fibula behind the tibia. Am J Roetgenol Radium Ther Nucl Med 76: 1102, 1956.Google Scholar
  29. 28.
    Ferreira AP, DeWet IS, Dommisse GF: Fractures and dislocations of the ankle joint. S Afr Med J 54: 1095, 1978.PubMedGoogle Scholar
  30. 29.
    Golterman AFL: Diagnosis and treatment of tibiofibular diastasis. Arch Chir Neerl 16: 185, 1964.PubMedGoogle Scholar
  31. 30.
    Grath G: Widening of the ankle mortise. A clinical and experimental study. Acta Chir Scand (Suppl) 263: 1, 1960.Google Scholar
  32. 31.
    Harvey JP Jr: Fractures of the ankle. A clinical survey of 181 cases. Clin Orthop 42: 57, 1965.PubMedGoogle Scholar
  33. 32.
    Henderson MS: Fractures of the ankle. Wisc Med J 31: 684, 1932.Google Scholar
  34. 33.
    Henderson MS, Stuck WG: Fractures of the ankle. Recent and old. J Bone Joint Surg 15: 882, 1933.Google Scholar
  35. 34.
    Hirsch C, Lewis J: Experimental ankle-joint fractures. Acta Orthop Scand 36: 408, 1965.PubMedCrossRefGoogle Scholar
  36. 35.
    Hughes J: The medial malleolus in ankle fractures. Orthop Clin North Am, 11: 649, 1980.PubMedGoogle Scholar
  37. 36.
    Hughes JL, Weber H, Willenegger H, Kuner EH: Evaluation of ankle fractures. Non-operative and operative treatment. Clin Orthop ReI Res 138: 111, 1979.Google Scholar
  38. 37.
    Hughes SPF: An historical review of fractures involving the ankle joint. Mayo Clin Proc 50: 611, 1975.PubMedGoogle Scholar
  39. 38.
    Hughes SPF: External rotational injury of the ankle joint with displacement of the talus. Ann Roy Coil Surg 59: 61, 1977.Google Scholar
  40. 39.
    Iselin M, deVellis H: La primaute du perone dans les fractures' du cou-de-pied. Mem Acad Chir 87: 399, 1961.Google Scholar
  41. 40.
    Iergesen F: Open reduction of fractures and dislocations of the ankle. Am I Surg 98: 136, 1959.CrossRefGoogle Scholar
  42. 41.
    Key lA, Conwell HE: Injuries in the Region of the Ankle. The Management of Fractures, Dislocations and Sprains, 6th ed. St. Louis, Mosby, 1956.Google Scholar
  43. 42.
    Kleiger B: The diagnosis and treatment of traumatic lateral ankle instability. NY State I Med 54: 2573, 1954.Google Scholar
  44. 43.
    Kleiger B: Treatment of oblique fractures of the fibula. I Bone Ioint Surg 43: 969, 1961.Google Scholar
  45. 44.
    Kleiger B: Mechanisms of ankle injury. Orthop Clin North Am 5: 127, 1974.PubMedGoogle Scholar
  46. 45.
    Klossner 0: Late results of operative and nonoperative treatment of severe ankle fractures. Acta Chir Scand (Suppl) 293: 1, 1962.Google Scholar
  47. 46.
    Kristensen T: Treatment of malleolar fractures according to Lauge-Hansen's method. Preliminary results. Acta Chir Scand 97: 362, 1949.PubMedGoogle Scholar
  48. 47.
    Kristensen T: Fractures of the ankle. VI. Follow- Up studies. AMA Arch Surg 73: 112, 1956.PubMedGoogle Scholar
  49. 48.
    Lane WA: The operative treatment of simple fractures. Surg Gynecol Obstet 8: 344, 1909.Google Scholar
  50. 49.
    Lauge-Hansen N: Fractures of the ankle. Arch Surg 56: 259, 1948.Google Scholar
  51. 50.
    Lauge-Hansen N: Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg 60: 957, 1950.PubMedGoogle Scholar
  52. 51.
    Lauge-Hansen N: Fractures of the ankle. IV. Clinical use of the genetic roentgen diagnosis and genetic reduction. Arch Surg 64: 488, 1952.Google Scholar
  53. 52.
    Lauge-Hansen N: Fractures of the ankle. V. Pronation-dorsiflexion fracture. Arch Surg 67: 813, 1953.Google Scholar
  54. 53.
    Lauge-Hansen N: Fractures of the ankle. III. Genetic roentgenologic diagnosis of fractures of the ankle. Am J Roentgenol 71: 456, 1954.Google Scholar
  55. 54.
    Lewin P: Fractures of the Bones of the Foot and Ankle. Philadelphia, Lea & Febiger, 1959.Google Scholar
  56. 55.
    Lewis IL: The effect of ankle-injury forces. I Bone Ioint Surg 46A: 1380, 1964.Google Scholar
  57. 56.
    Lindsjo U: Operative treatment of ankle fractures. Acta Orthop Scand (Suppl) 189: 1, 1981.Google Scholar
  58. 57.
    Lovell ES: An unusual rotatory injury of the ankle. I Bone Ioint Surg 50A: 163, 1968.Google Scholar
  59. 58.
    MacKinnon AP: Fracture of the lower articular surface of the tibia in fracture dislocation of the ankle. J Bone Joint Surg 10:352, 1928. 59. Magnusson R: On the late results in non-operated cases of malleolar fractures. I. Fractures by external rotation. Acta Chir Scand (Suppl) 84:1, 1944. 60. Magnusson R: Ligament injuries of the ankle joint. Acta Orthop Scand 36: 317, 1965.Google Scholar
  60. 61.
    Maisonneuve MJG: Fractures du perone, Arch Gen Med 1: 165, 1840.Google Scholar
  61. 62.
    MaIka IS, Taillard W: Results of non-operative and operative treatment of fractures of the ankle. Clin Orthop ReI Res 67:159, 1969.Google Scholar
  62. 63.
    Mast JW, Teipner A: A reproducible approach to the internal fixation of adult ankle fractures. Rationale, technique, and early results. Orthop Clin North Am 11: 661, 1980.PubMedGoogle Scholar
  63. 64.
    Mayer PJ, Evarts CMcC: Fracture-dislocation of ankle with posterior entrapment of the fibula behind the tibia. Recognition and management. Bone Joint Surg 6OA: 320, 1978.Google Scholar
  64. 65.
    McDaniel WJ, Wilson FC: Trimalleolar fractures of the ankle. An end result study. Clin Orthop ReI Res 122: 37, 1977.Google Scholar
  65. 66.
    McLaughlin HL: Trauma. Philadelphia, Saunders, 1960.Google Scholar
  66. 67.
    Meyers MH: Fracture about the ankle joint with fixed displacement of the proximal fragment of the fibula behind the tibia. J Bone Joint Surg 39A: 441, 1957.PubMedGoogle Scholar
  67. 68.
    Meyers MH: Fracture about the ankle joint with fixed displacement of the proximal fragment of the fibula behind the tibia. Clin Orthop ReI Res 42: 67, 1965.Google Scholar
  68. 69.
    Monk CJE: Injuries of the tibiofibular ligaments. J Bone Joint Surg 51: 330, 1969.Google Scholar
  69. 70.
    MullerME, Allgower M, Schneider R, Willenegger H: Manual of Internal Fixation. New York, Springer-Verlag, 1979.Google Scholar
  70. 71.
    Neer CS II: Injuries of the ankle joint. Evaluation. Conn State Med I 17: 580, 1953.Google Scholar
  71. 72.
    Neufeld AJ: Ankle joint fractures and their treatment. Clin Orthop 42: 91, 1965.PubMedGoogle Scholar
  72. 73.
    Nystrom G: A contribution to the treatment of fractures of the posterior border of the tibia by malleolar fractures. Acta Radiol 25: 672, 1944.CrossRefGoogle Scholar
  73. 74.
    Olerud S: Subluxation of the ankle without fracture of the fibula. A case report. J Bone Joint Surg 53A: 594, 1971.PubMedGoogle Scholar
  74. 75.
    Pankovich AM: Fractures of the fibula proximal to the distal tibiofibular syndesmosis. J Bone Joint Surg 6OA: 221, 1978.Google Scholar
  75. 76.
    Pankovich AM: Fractures of the fibula at the distal tibiofibular syndesmosis. Clin Orthop ReI Res 143: 138, 1979.Google Scholar
  76. 77.
    Pankovich AM: Adult ankle fractures. JCE Orthop 7: 17, 1979.CrossRefGoogle Scholar
  77. 78.
    Phillips RS, Balmer GA, Monk CJE: The external rotation fracture of the fibular malleolus. Br I Surg 56: 55, 1969.Google Scholar
  78. 79.
    Phillips WA, Spiegel PG: Evaluation of ankle fractures, non-operative vs. operative. Clin Orthop ReI Res 138: 17, 1979.Google Scholar
  79. 80.
    Platt H: Introduction to a discussion on fractures in the neighborhood of the ankle-joint. Lancet 1: 33, 1926.CrossRefGoogle Scholar
  80. 81.
    Pott P: Some Few General Remarks on Fractures and Dislocations. London, Hawes, Clarke and Collins, 1768. Reprinted in Med Classics 1: 329, 1936.Google Scholar
  81. 82.
    Purvis GD: The unstable oblique distal fibular fracture. Clin Orthop ReI Res 92: 330, 1973.CrossRefGoogle Scholar
  82. 83.
    Quigley TB: Analysis and treatment of ankle injuries produced by rotatory, abduction and adduction forces. Instructional Course Lectures Am Acad Orthop Surg 19: 172, 1970.Google Scholar
  83. 84.
    Rang M: Ant4010gy of Orthopaedics. Edinburgh, Churchill Livingstone, 1966.Google Scholar
  84. 85.
    Riitt A: Surgery of the Lower Leg and Foot. Translated by G. Stiasny. Philadelphia, Saunders, 1980.Google Scholar
  85. 86.
    Sarkisian JS, Cody GW: Closed treatment of ankle fractures. A new criterion for evaluation-a review of 250 cases. J Trauma 16: 323, 1976.PubMedCrossRefGoogle Scholar
  86. 87.
    Schatzker J, McBroom R, Dzioba R: Irreducible fracture dislocation of the ankle due to posterior dislocation of the fibula. J Trauma 17: 397, 1977.PubMedCrossRefGoogle Scholar
  87. 88.
    Sisk TD: In Edmonson AP, Crenshaw AH (eds): Campbell's Operative Orthopaedics, 6th ed. St. Louis, Mosby, 1980.Google Scholar
  88. 89.
    Solonen KA, Lauttamus L: Treatment of malleolar fractures. Acta Orthop Scand 36: 321, 1965.PubMedGoogle Scholar
  89. 90.
    Solonen KA, Lauttamus L: Operative treatment of ankle fractures. Acta Orthop Scand 39: 223, 1968.PubMedCrossRefGoogle Scholar
  90. 91.
    Staples OS: Injuries to the medial ligaments of the ankle. J Bone Joint Surg 42A: 1287, 1960.Google Scholar
  91. 92.
    Staples OS: Ligamentous injuries of the ankle joint. Clin Orthop 42: 21, 1965.PubMedGoogle Scholar
  92. 93.
    Stimson LA: Pott's fracture at the ankle. NY Med J 55: 701, 1892.Google Scholar
  93. 94.
    Tanton J: Fractures du Membre Inferieur. Librairie J.-B. Bailliere et Fils Paris, 1916.Google Scholar
  94. 95.
    Vasli S: Operative treatment of ankle fractures. Acta Chir Scand (Suppl) 226: 1, 1957.Google Scholar
  95. 96.
    Wagstaffe WW: An unusual form of fracture of the fibula. St Thomas Hosp Rep 6: 43, 1875.Google Scholar
  96. 97.
    Walheim T: Intra-articular malleolar fractures. A survey. Acta Chir Scand 79: 166, 1937.Google Scholar
  97. 98.
    Walsh WM, Hughston JC: Unstable ankle fractures in athletes. Am J Sports Med 4: 173, 1976.PubMedCrossRefGoogle Scholar
  98. 99.
    Watson-Jones R: Fractures and Other Joint Injuries, 4th ed. Baltimore, Williams & Wilkins, 1955.Google Scholar
  99. 100.
    Weber BG: Die Verletzungen des oberenSprunggelenkes. In: Aktuelle Probleme in der Chirurgie. Bern, Verlag Hans Huber, 1966.Google Scholar
  100. 101.
    Wilson FC Jr, Skilbred LA: Long-term results in the treatment of displaced bimalleolar fractures. J Bone Joint Surg 48A: 1065, 1966.PubMedGoogle Scholar
  101. 102.
    Woods RS: Irreducible dislocation of the anklejoint. Br J Surg 29: 359, 1942.CrossRefGoogle Scholar
  102. 103.
    Yde J: The Lauge-Hansen classification of malleolar fractures. Acta Orthop Scand 51: 181, 1980.PubMedCrossRefGoogle Scholar
  103. 104.
    Yde J, Kristensen KD: Ankle fractures. Supination-eversion fractures stage II. Primary and late results of operative and non-operative treatment. Acta Orthop Scand 51: 695, 1980.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1984

Authors and Affiliations

  • William C. Hamilton

There are no affiliations available

Personalised recommendations